1. Field of the Invention
This invention relates to drug administration in a patient and patient simulator mannequin for use in training physicians and other medical personnel in anesthesiology and emergency room procedures, and recording actual drugs administered to a patient, and in particular to a patient and patient simulator drug recognition system that identifies the type, concentration, and amount of simulated drug being administered to the patient mannequin, or the type, concentration, and amount of actual drug being administered to the patient.
2. Description of Related Art
Almost all training of anesthesiologists has been by having the student doctor observe numerous actual patients being anesthetized by one or more skilled anesthesiologists. The anesthesiologist must remain present during the patient treatment or operation for the entire period that the patient is being anesthetized. Thus, in the training cycle, typically, the students will also be required to spend several hours as observers. Such a training procedure is extremely costly, and provides little guarantee that every student will be able to observe all possible emergency problems that can arise during the time period that the patient is anesthetized. Obviously, during an actual patient operation, there is no opportunity to practice typical or even unexpected emergencies that could happen during the actual process.
There are presently available patient simulator mannequins to train medical personnel in anesthesiology and emergency room medicine. These mannequins may have capabilities featuring spontaneous breathing and mechanical ventilation, thumb twitch in response to nerve stimulus, heart and breath sounds, pulses, and a complete airway anatomy for intubation and difficult airway training. Examples of anesthesiology simulator mannequins are disclosed in U.S. Pat. No. 5,403,192 issued to Kleinwaks et al., the disclosure of which is incorporated herein by reference.
Using patient simulator mannequins, the student can develop skills in manual dexterity and diagnosis, recognize symptoms immediately, prescribe the right remedy, and correct the patient's condition, with none of the inherent risk to a real patient.
Mannequins are particularly important for training in crisis management of critical events that happen rarely, especially in anesthesiology. The mannequins are typically computer controlled and can be programmed for a variety of responses which simulate a variety of problems.
A student doctor undergoing anesthesiology training in a simulator will see a mannequin representing the patient, and can utilize required anesthesia equipment such as ventilators exactly like the equipment found in any operating room. He or she can ventilate the simulator's mannequin by mask, or the trachea can be intubated. When connected to an anesthesia gas machine, anesthetic gases and air or oxygen will be delivered to the mannequin, which, under computer control, will return gases containing the appropriate amount of carbon dioxide. The trainee is observed by another anesthesiologist acting as an instructor, who will enter certain information about these observations into the computer.
For enhanced realistic training, the present invention allows the trainee to administer intravenous (IV) injections of simulated drugs to the mannequin, and these simulated drugs will be monitored and registered in accordance with the invention described herein.
Monitors and instruments will be driven in some cases by the gases exhaled by the mannequin, and in other cases by the computer through output equipment or "linkage" (interface circuitry). The trainee may apply a nerve stimulator to the mannequin, which will respond accordingly; the mannequin will also exhibit a number of other relevant clinical signs, for example breath sounds or heart sounds audible with a stethoscope. Through these simulated human responses, and through the use of mathematical models of internal body processes, the computer and mannequin can simulate the condition of a human patient who has been subjected to the anesthetics and other drugs given to the mannequin.
An anesthesiology simulator product may contain, and is organized around, a list of the following mannequin and associated components parts:
Dummies (mannequins) for training in the insertion of tubes directly into the trachea or windpipe ("endotracheal intubation") for the administration of anesthetics are commercially available; they are plastic models which are anatomically correct throughout the mouth, throat, larynx, trachea, esophagus, and bronchial tubes. For the anesthesiology trainer described herein, the mannequin will also have the following added capabilities:
"Lungs," which can ventilate spontaneously as well as passively through hand ventilation or a mechanical ventilator. The lungs will be made to inflate spontaneously through the movement of a bellows (actuated from the computer). The spontaneous inflation of the bellows can be turned off, in which case any ventilation will be that induced through hand ventilation or mechanical ventilation.
Speakers, providing heart sounds that can be detected with a stethoscope. These sounds will be modified according to the calculated heart rate. Selection of sounds will reflect various heart conditions as determined by math models.
Devices in the mainstem bronchi are employed which can be caused to block a bronchus, thus simulating the inability of the associated lung to receive delivered gas.
Palpable pulses, at both the carotid artery and the radial artery can be generated.
As over 70 different types of drugs can be used in actual anesthesiology, a system to determine the type, concentration, and amount of drug administered to the mannequin patient is needed for proper and more realistic patient simulator training.
An extremely important aspect of anesthetizing a patient in a conventional operating room setting is the requirement that the patient receive fluids and drugs through IV devices. Typically, an IV fluid bag is connected to a patient, usually in the arm of the patient. The fluid bag is connected to an injection port manifold, where the contents of several different syringes can be individually and independently added into the fluid flow prior to entering the patient. Immediate IV access to the patient can be critical during an emergency situation for administering a necessary drug quickly. Critical to the well being of the patient, obviously, is to ensure that the proper fluids or drugs are given to the patient in the anesthesiology and operating room environment.
Therefore, for anesthesiology simulation, and in particular the patient simulator, it is important to train and simulate drug administration and registration and to know the type of each drug being injected into the patient, as well as the amount for training evaluation. In the case of a simulator, the simulated patient is a mannequin that can include a mannequin arm simulating a human arm, an IV bag, an injection port manifold for the distribution of real liquids, such as water, that simulate the liquid flow of certain drugs, each having port openings that can be connected to syringes for simulated injection of drugs into the mannequin patient. It is also important that the drug recognition equipment be as "invisible" as possible in the simulated operating room environment to minimize the amount of equipment that would not be present in the actual operating room. In training and simulation, it is also desirous not to add any specific operational steps to the act of injecting the drugs, other than those that would normally be performed on a typical patient in an operating room.
In accordance with the invention described herein, a system is provided for drug recognition for manual delivery by the trainee of simulated drugs into one or more places, typically in the mannequin's arm, into which intravenous (IV) simulated fluids and drugs can be inserted to enhance realism and training.
In addition, in real operating and emergency rooms there exists a need for a system to automatically record the type of drug, concentration, and quantity administered, and the time of administration to the patient.